Glaucoma epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rohan Bir Singh, M.B.B.S.[2]

Epidemiology and Demographics

Prevalence

  • The global prevalence of glaucoma for population aged 40–80 years is 3.54% (95% Confidence Interval, 2.09–5.82). The prevalence of POAG is highest in Africa - 4.20% (95% Confidence Interval, 2.08–7.35). In 2013, the number of people (aged 40–80 years) with glaucoma worldwide was estimated to be 64.3 million, increasing to 76.0 million in 2020 and 111.8 million in 2040.[1]
  • Glaucoma affects one in two hundred people aged fifty and younger and one in ten over the age of eighty.
  • Worldwide, it is the second leading cause of blindness.[2]

Primary Open-Angle Glaucoma

The overall prevalence of OAG in the US population 40 years and older is estimated to be 1.86% (95% confidence interval, 1.75%-1.96%), with 1.57 million white and 398000 black persons affected. After applying race-, age-, and gender-specific rates to the US population as determined in the 2000 US census, it was estimated that OAG affects 2.22 million US citizens. Owing to the rapidly aging population, the number with OAG will increase by 50% to 3.36 million by 2020. [3]

Age

  • In Rotterdam and Barbados study, there is a significant increase in the prevalence of glaucoma in older individuals, with estimates for persons in their 70s being generally 3 to 8 times higher than those for persons in their 40s. In addition, multiple population-based surveys have demonstrated a higher prevalence of glaucoma in specific ethnic groups.[4][5]


Gender

  • In the Bayesian meta-regression model, men were more likely to have POAG than women (odds ratio [OR], 1.36; 95% CrI, 1.23–1.52), and after adjusting for age, gender, habitation type, response rate, and year of study, people of African ancestry were more likely to have POAG than people of European ancestry (OR, 2.80; 95% CrI, 1.83–4.06), and people living in urban areas were more likely to have POAG than those in rural areas (OR, 1.58; 95% CrI, 1.19–2.04).[1]

Race

  • Among whites aged 40 years and older, a prevalence of between 1.1% and 2.1% has been reported based on population-based studies performed throughout the world.
  • The prevalence among black persons and Latino persons is up to 4 times higher compared to the prevalence among whites. Black individuals are also at greater risk of blindness from POAG, and this risk increases with age: in persons aged 46-65 years, the likelihood of blindness from POAG is 15 times higher among blacks than that among whites.

Primary Angle Closure Glaucoma

The prevalence of PACG is highest in Asia - 1.09%; (95% Confidence Interval, 0.43–2.32)[3]

Age

  • The depth and volume of the anterior chamber decrease with age. These changes predis- pose the eye to pupillary block; thus, the prevalence of angle-closure glaucoma with pupil- lary block increases with age. Acute angle-closure glaucoma is most common between the ages of 55 and 65 years, but it can occur in young adults and has been reported in children.

Gender

  • Acute angle-closure glaucoma has been reported more often in women than in men, and several population-based surveys show that women are at increased risk of angle-closure glaucoma. Studies of normal eyes have shown that women have shallower anterior cham- bers than men. Pooyan 66961526-7

Race

  • The prevalence of primary angle-closure glaucoma (PACG) varies among different racial and ethnic groups. Among white populations in the United States and Europe, it is esti mated at 0.1%. Inuit populations from the Arctic regions have the highest-known prevalence of PACG about 20 to 40 times higher than that for whites. Although estimates of the prevalence of PACG in Asian populations vary widely, available data suggest that for most Asian population groups, the prevalence of PACG is between that for whites and that for the Inuit. Some studies have suggested that the prevalence ofPACG among blacks is simi- lar to that among whites, with most cases among black persons being of the chronic variety.

Refraction

  • Although PACG may occur in eyes with any type of refractive error, it is typically associ- ated with hyperopia. The depth and volume of the anterior chamber are reduced in hyper- opic eyes, predisposing them to PACG.

Inheritance

  • Some of the anatomical features of the eye that predispose to pupillary block, such as a more anterior lens position and greater-than-average lens thickness, are inherited. Al- though generalizable estimates are lacking, a population-based survey in China suggests that a family history of glaucoma increases the risk of PACG sixfold.

References

  1. 1.0 1.1 Yih-Chung Tham, Xiang Li, Tien Y. Wong, Harry A. Quigley, Tin Aung, Ching-Yu Cheng (2014). "Global Prevalence of Glaucoma and Projections of Glaucoma Burden through 2040". Ophthalmology. 121 (11): 2081–2090. doi:10.1016/j.ophtha.2014.05.013.
  2. "Glaucoma, Normal Tension, Susceptibility To." OMIM - Online Mendelian Inheritance in Man. Accessed October 17, 2006.
  3. 3.0 3.1 Friedman DS, Wolfs RC, O'Colmain BJ, Klein BE, Taylor HR, West S, Leske MC, Mitchell P, Congdon N, Kempen J, Eye Diseases Prevalence Research Group (2004). "Prevalence of Open-Angle Glaucoma Among Adults in the United States". Arch Ophthalmol. 122 (4): 532–8. doi:10.1001/archopht.122.4.532. PMC 2798086. PMID 15078671.
  4. Dielemans, Ida; Vingerling, Johannes R.; Wolfs, Roger C.W.; Hofman, Albert; Grobbee, Diederick E.; de Jong, Paulus T.V.M. (1994). "The Prevalence of Primary Open-angle Glaucoma in a Population-based Study in The Netherlands". Ophthalmology. 101 (11): 1851–1855. doi:10.1016/S0161-6420(94)31090-6. ISSN 0161-6420.
  5. Leske, M. Cristina (1994). "The Barbados Eye Study". Archives of Ophthalmology. 112 (6): 821. doi:10.1001/archopht.1994.01090180121046. ISSN 0003-9950.

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